Message from the Division Director
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Dear colleagues,
It feels like a lot has changed over the past few weeks. We’ve moved from initial intensive planning in the face of uncertainty, to dramatically expanding virtual outpatient care, to caring for the first wave of inpatients with COVID-19, to settling in to new workflows and protocols. Those of us who have been providing inpatient care have noted common challenges: the fatigue that comes from the need to pay strict attention to personal protective equipment, the sadness engendered by some of the experiences of patients and families (see Ed Etchells’ post here), the obstacles to monitoring and communicating with patients in isolation, and the ongoing concern about the impact of COVID-19 on those in long-term care facilities and shelters, not to mention on ourselves and our families. At the same time, most have found the experience less daunting than anticipated. Patient care is inherently rewarding, and our hospitals have been characterized by a remarkable spirit of collegiality and esprit-de-corps. It turns out wearing scrubs and surgical clogs is really comfortable and convenient. And across the city, people have collaborated to rapidly develop useful clinical tools, orientation manuals, quality improvement interventions and clinical trials.
We have not seen the overwhelming surge in cases we had feared, but it is likely that we will continue to provide a substantial amount of COVID-19 care in the coming months and that our GIM volumes will increase to pre-COVID levels. As we now face the long haul, we will need to continue to adapt our schedules and processes, engage our non-GIM colleagues as appropriate, and ensure that we incorporate time for rest and recovery so that our work is sustainable.
I am tremendously proud of how our division has responded to this crisis with energy, innovation, professionalism and compassion. As always, please let me know if you have any suggestions, concerns or comments.
With thanks for everything you do,
Moira
Dr. Moira Kapral
Director, Division of GIM, University of Toronto
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Zac Feilchenfeld Receives PB Academy Award
Zac Feilchenfeld has been awarded the Peters Boyd Academy Award for Clerkship Teaching. Congratulations!
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Mark Bonta Appointed MAID Lead, UHN
Mark Bonta has been appointed lead of the Medical Assistance in Dying program at the University Health Network. He has been serving as interim lead for the past six months and has skilfully advanced the work and priorities of the program.
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GIM Clinical Resources for Ward COVID Care
The Toronto COVID Collective has developed helpful resources for ward-based COVID-19 workflow and patient care. This citywide initiative was led by faculty from UHN with web design by Alison Lai, PGY5 in GIM.
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Job Postings
Sunnybrook Health Sciences Centre Division of General Internal Medicine is seeking a Clinician Teacher. Details here.
St. Michael's Hospital Division of General Internal Medicine is seeking a Clinician Teacher. Details here.
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Perioperative Care Congress
The Perioperative Care Congress will be held Nov. 6-8, 2020 in Toronto. Details here.
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Journal Articles
Divisional members have published the following journal articles since the last issue of the GIM Update.
1. Physician-level variation in clinical outcomes and resource use in inpatient general internal medicine: an observational study.
Verma AA, Guo Y, Jung HY, Laupacis A, Mamdani M, Detsky AS, Weinerman A, Tang T, Rawal S,
Lapointe-Shaw L, Kwan JL, Razak F.
BMJ Qual Saf. 2020 Mar 27. pii: bmjqs-2019-010425. doi: 10.1136/bmjqs-2019-010425.
2. Pharmacologic Treatments and Supportive Care for Middle East Respiratory Syndrome.
Kain T, Lindsay PJ, Adhikari NKJ, Arabi YM, Van Kerkhove MD, Fowler RA.
Emerg Infect Dis. 2020 Mar 26;26(6). doi: 10.3201/eid2606.200037. [Epub ahead of print]
PMID: 32213260
3. Impact of diabetes, obesity and hypertension on preterm birth: Population-based study.
Berger H, Melamed N, Davis BM, Hasan H, Mawjee K, Barrett J, McDonald SD, Geary M, Ray JG.
PLoS One. 2020 Mar 25;15(3):e0228743. doi: 10.1371/journal.pone.0228743. eCollection 2020.
PMID: 32210434 [PubMed - in process] Free PMC Article
4. Determinants of Direct Discharge Home From Critical Care Units: A Population-Based Cohort Analysis.
Martin CM, Lam M, Allen B, Richard L, Lau V, Ball IM, Wunsch H, Fowler RA, Scales DC.
Crit Care Med. 2020 Apr;48(4):475-483. doi: 10.1097/CCM.0000000000004178.
PMID: 32205593
5. Quarantine.
Coomes EA, Leis JA, Gold WL.
CMAJ. 2020 Mar 20. pii: cmaj.200393. doi: 10.1503/cmaj.200393. [Epub ahead of print] No abstract available. PMID: 32198177
6. Resident Perceptions of Assessment and Feedback in Competency-Based Medical Education: A Focus Group Study of One Internal Medicine Residency Program.
Branfield Day L, Miles A, Ginsburg S, Melvin L.
Acad Med. 2020 Mar 17. doi: 10.1097/ACM.0000000000003315.
PMID: 32195692
7. Joint trajectories of disease activity, and physical and mental health-related quality of life in an inception lupus cohort.
Fung W, Lim LSH, Tomlinson G, Engel L, Su J, Diaz-Martinez JP, Touma Z. Rheumatology (Oxford). 2020 Mar 19. pii: keaa091. doi: 10.1093/rheumatology/keaa091.
PMID: 32191334
8. Using real-world safety data in regulatory approval decisions: Sotagliflozin and the risk of diabetic ketoacidosis.
Fralick M, Kesselheim AS.
Pharmacoepidemiol Drug Saf. 2020 Mar 18. doi: 10.1002/pds.4994.
PMID: 32189390
9. Hearing loss and hearing needs in an adult homeless population: a prospective cross-sectional study.
Noel CW, Mok F, Wu V, Eskander A, Yao CMKL, Hwang SW, Lichter M, Reekie M, Smith S,
Syrett I, Zirkle M, Lin V, Lee JM.
CMAJ Open. 2020 Mar 16;8(1):E199-E204. doi: 10.9778/cmajo.20190220. Print 2020 Jan-Mar.
PMID: 32184284
10. Hospital admission for stroke or transient ischemic attack among First Nations people with diabetes in Ontario: a population-based cohort study.
Kapral MK, Shah BR, Green ME, Porter J, Griffiths R, Frymire E, Slater M, Jacklin K, Sutherland
R, Walker JD.
CMAJ Open. 2020 Mar 16;8(1):E156-E162. doi: 10.9778/cmajo.20190199. Print 2020 Jan-Mar.
PMID: 32184279
11. Working together to contain and manage COVID-19.
Laupacis A.
CMAJ. 2020 Mar 17. pii: cmaj.200428. doi: 10.1503/cmaj.200428. [Epub ahead of print] No abstract available.
PMID: 32184199 [PubMed - as supplied by publisher]
12. Association between Chinese or South Asian ethnicity and end-of-life care in Ontario, Canada.
Yarnell CJ, Fu L, Bonares MJ, Nayfeh A, Fowler RA.
CMAJ. 2020 Mar 16;192(11):E266-E274. doi: 10.1503/cmaj.190655.
PMID: 32179535 [PubMed - in process]
13. Comparing Childhood Cancer Care Costs in Two Canadian Provinces.
McBride ML, de Oliveira C, Duncan R, Bremner KE, Liu N, Greenberg ML, Nathan PC, Rogers PC, Peacock SJ, Krahn MD.
Healthc Policy. 2020 Feb;15(3):76-88. doi: 10.12927/hcpol.2020.26129.
PMID: 32176612
14. Haemoglobin levels in early pregnancy and severe maternal morbidity: population-based cohort study.
Ray JG, Davidson A, Berger H, Dayan N, Park AL.
BJOG. 2020 Mar 16. doi: 10.1111/1471-0528.16216. [Epub ahead of print]
PMID: 32175668
15. PROM-ED: Development and Testing of a Patient-Reported Outcome Measure for Emergency Department Patients Who Are Discharged Home.
Vaillancourt S, Cullen JD, Dainty KN, Inrig T, Laupacis A, Linton D, Malherbe S, Maybee A, Schull MJ, Seaton MB, Beaton DE. Ann Emerg Med. 2020 Mar 12. pii: S0196-0644(19)31464-7. doi:10.1016/j.annemergmed.2019.12.023. [Epub ahead of print]
PMID: 32173134 [PubMed - as supplied by publisher]
16. Extending cytomegalovirus prophylaxis in high-risk (D+/R-) lung transplant recipients from 6 to 9 months reduces cytomegalovirus disease: A retrospective study.
Herrera S, Khan B, Singer LG, Binnie M, Chaparro C, Chow CW, Martinu T, Tomlinson G, Keshavjee S, Husain S, Tikkanen JM.
Transpl Infect Dis. 2020 Mar 14:e13277. doi: 10.1111/tid.13277. [Epub ahead of print]
PMID: 32170813 [PubMed - as supplied by publisher]
17. Age differences in patterns and confidence of using internet and social media for cancer-care among cancer survivors.
Eng L, Bender J, Hueniken K, Kassirian S, Mitchell L, Aggarwal R, Paulo C, Smith EC, Geist I, Balaratnam K, Magony A, Liang M, Yang D, Jones JM, Brown MC, Xu W, Grover SC, Alibhai SMH, Liu G, Gupta AA.
J Geriatr Oncol. 2020 Mar 10. pii: S1879-4068(19)30462-X. doi: 10.1016/j.jgo.2020.02.011
PMID: 32169545 [PubMed - as supplied by publisher]
18. Care for Critically Ill Patients With COVID-19.
Murthy S, Gomersall CD, Fowler RA.
JAMA. 2020 Mar 11. doi: 10.1001/jama.2020.3633. [Epub ahead of print] No abstract available.
PMID: 32159735 [PubMed - as supplied by publisher]
19. Top ten priorities for anesthesia and perioperative research: a report from the Canadian Anesthesia Research Priority Setting Partnership.
McKeen DM, Banfield JC, McIsaac DI, McVicar J, McGavin C, Earle MA, Ward C, Burns KK, Penner D, Blaise G, de Greef T, Cowan K, Laupacis A; Perioperative Anesthesia Clinical Trials Group (PACT).
Can J Anaesth. 2020 Mar 10. doi: 10.1007/s12630-020-01607-6. [Epub ahead of print]
PMID: 32157588 [PubMed - as supplied by publisher]
20. Associations between self-reported physical activity, quality of life, and emotional well-being in men with prostate cancer on active surveillance.
Papadopoulos E, Alibhai SMH, Doré I, Matthew AG, Tomlinson GA, Nesbitt M, Finelli A, Trachtenberg J, Santa Mina D.
Psychooncology. 2020 Mar 10. doi: 10.1002/pon.5375. [Epub ahead of print]
PMID: 32154965 [PubMed - as supplied by publisher]
21. Long-term use of 5-alpha-reductase inhibitors is safe and effective in men on active surveillance for prostate cancer.
Finelli A, Komisarenko M, Martin LJ, Timilshina N, Jain K, Morris J, Zlotta A, Kulkarni G, Perlis N, van der Kwast T, Evans A, Ghai S, Fleshner N, Alibhai SMH, Hamilton RJ.
Prostate Cancer Prostatic Dis. 2020 Mar 9. doi: 10.1038/s41391-020-0218-2. [Epub ahead of print]
PMID: 32152437 [PubMed - as supplied by publisher]
22. Appropriateness of peripherally inserted central catheter use among general medical inpatients: an observational study using routinely collected data.
Verma AA, Kumachev A, Shah S, Guo Y, Jung HY, Rawal S, Lapointe-Shaw L, Kwan JL, Weinerman A, Tang T, Razak F.
BMJ Qual Saf. 2020 Mar 8. pii: bmjqs-2019-010463. doi: 10.1136/bmjqs-2019-010463. PMID: 32152091 [PubMed - as supplied by publisher]
23. Clinical guideline for homeless and vulnerably housed people, and people with lived homelessness experience.
Pottie K, Kendall CE, Aubry T, Magwood O, Andermann A, Salvalaggio G, Ponka D, Bloch G, Brcic V, Agbata E, Thavorn K, Hannigan T, Bond A, Crouse S, Goel R, Shoemaker E, Wang JZJ, Mott S, Kaur H, Mathew C, Hashmi SS, Saad A, Piggott T, Arya N, Kozloff N, Beder M, Guenter D, Muckle W, Hwang S, Stergiopoulos V, Tugwell P.
CMAJ. 2020 Mar 9;192(10):E240-E254. doi: 10.1503/cmaj.190777. No abstract available.
PMID: 32152052 [PubMed - in process]
24. Effectiveness and Safety of Apixaban Compared With Rivaroxaban for Patients With Atrial Fibrillation in Routine Practice: A Cohort Study.
Fralick M, Colacci M, Schneeweiss S, Huybrechts KF, Lin KJ, Gagne JJ.
Ann Intern Med. 2020 Mar 10. doi: 10.7326/M19-2522. [Epub ahead of print]
PMID: 32150751 [PubMed - as supplied by publisher]
25. Resilience and Adverse Childhood Experiences: Associations With Poor Mental Health Among Homeless Adults.
Liu M, Mejia-Lancheros C, Lachaud J, Nisenbaum R, Stergiopoulos V, Hwang SW.
Am J Prev Med. 2020 Mar 5. pii: S0749-3797(20)30042-8. doi: 10.1016/j.amepre.2019.12.017. [Epub ahead of print] PMID: 32147372 [PubMed - as supplied by publisher]
26. Tackling the void: the importance of addressing absences in the field of health professions education research.
Paton M, Kuper A, Paradis E, Feilchenfeld Z, Whitehead CR.
Adv Health Sci Educ Theory Pract. 2020 Mar 6. doi: 10.1007/s10459-020-09966-x. [Epub ahead of print] PMID: 32144528 [PubMed - as supplied by publisher]
27. Effects of six months of aerobic and resistance training on metabolic markers and bone mineral density in older men on androgen deprivation therapy for prostate cancer.
Papadopoulos E, Mina DS, Culos-Reed N, Durbano S, Ritvo P, Sabiston CM, Krahn M, Tomlinson G, O'Neill M, Iqbal A, Timilshina N, Matthew A, Warde P, Alibhai SMH.
J Geriatr Oncol. 2020 Mar 3. pii: S1879-4068(19)30378-9. doi: 10.1016/j.jgo.2020.02.013. [Epub ahead of print]
PMID: 32143995 [PubMed - as supplied by publisher]
28. Adverse Drug Events in Older Adults: Review of Adjudication Methods in Deprescribing Studies.
Ross MSc Candidate SB, Wu PE, Atique Md Candidate A, Papillon-Ferland L, Tamblyn R, Lee TC, McDonald EG.
J Am Geriatr Soc. 2020 Mar 6. doi: 10.1111/jgs.16382. [Epub ahead of print] Review.
PMID: 32142161 [PubMed - as supplied by publisher]
29. Preprints: a Timely Counterbalance for Big Data-Driven Research.
Verma AA, Detsky AS.
J Gen Intern Med. 2020 Mar 5. doi: 10.1007/s11606-020-05746-w. [Epub ahead of print]
PMID: 32141042 [PubMed - as supplied by publisher]
30. Patient and caregiver experience in the transition from hospital to home - brainstorming results from group concept mapping: a patient-oriented study.
Kiran T, Wells D, Okrainec K, Kennedy C, Devotta K, Mabaya G, Phillips L, Lang A, O'Campo P.
CMAJ Open. 2020 Mar 2;8(1):E121-E133. doi: 10.9778/cmajo.20190009. Print 2020 Jan-Mar.
PMID: 32127383
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Publications and Other Contributions by Trainees
1. Quarantine.
Coomes EA, Leis JA, Gold WL.
CMAJ. 2020 Mar 20. pii: cmaj.200393. doi: 10.1503/cmaj.200393. [Epub ahead of print] No abstract available. PMID: 32198177
2. Resident Perceptions of Assessment and Feedback in Competency-Based Medical Education: A Focus Group Study of One Internal Medicine Residency Program.
Branfield Day L, Miles A, Ginsburg S, Melvin L.
Acad Med. 2020 Mar 17. doi: 10.1097/ACM.0000000000003315.
PMID: 32195692
Trainees: please email joe.graves@uhn.ca if you have items for inclusion in this section.
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